Portaleone D, Melandri M, Ranieri G, Tomasini M, Ghiani M, Signori S, Di Leo M, Varenna R
Pediatr Med Chir. 1986 Mar-Apr;8(2):281-4.
Serum levels of bilirubin and of other four enzymes known to be elevated in liver diseases were measured preoperatively and controlled on the first and fourth postoperative day in 14 children with chronic liver disease and anesthetised for liver biopsy using Ketamine (7 patients, group A) or other drugs (group B). Serum levels of gamma GT, Ph. Alk, direct and indirect bilirubin show neither significant variations nor differences between the two groups of patients. SGOT and SGPT basal levels were similar in the two groups and were rather two-fold the normal values. At the first postoperative day, in group B only SGOT levels increased significantly. Moreover, their increase over the basal levels monitored at the first day was significantly lower in the group of patients anesthetised with Ketamine than in group B. In group A, SGPT values were constant showing a small, non significant decrease, while in group B, above levels present a significant increase at the postoperative day and a significant difference between the two groups. At the fourth day, SGOT and SGPT differences versus basal values were not significant. Our experience shows that - as known by normal subjects - Ketamine has no hepatic toxicity in pediatrics patients affected by chronic liver disease, too. Finally, our study suggests that Ketamine must be used in hepatopath children whenever they have to be submitted to total anesthesia.
对14例患有慢性肝病且接受氯胺酮麻醉（7例，A组）或其他药物麻醉（B组）以进行肝活检的儿童，术前测定其血清胆红素水平以及其他四种已知在肝病中会升高的酶水平，并在术后第1天和第4天进行监测。γ-GT、碱性磷酸酶、直接胆红素和间接胆红素的血清水平在两组患者中均未显示出显著变化或差异。两组的谷草转氨酶（SGOT）和谷丙转氨酶（SGPT）基础水平相似，约为正常值的两倍。术后第1天，仅B组的SGOT水平显著升高。此外，氯胺酮麻醉组患者相对于第一天监测的基础水平的升高显著低于B组。在A组中，SGPT值保持稳定，略有下降但不显著，而在B组中，术后水平显著升高，两组之间存在显著差异。在第4天，SGOT和SGPT与基础值的差异不显著。我们的经验表明——正如正常受试者所知——氯胺酮对患有慢性肝病的儿科患者也没有肝毒性。最后，我们的研究表明，只要患有肝病的儿童必须接受全身麻醉，就必须使用氯胺酮。
